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Nursing, LPN, Year 1 > X Foundations - Chp 4, Vital Signs > Flashcards

X Foundations - Chp 4, Vital Signs Flashcards

1
Q

How is heat produced in the body

A
  • muscles, shivering

- metabolism (burn ATP)

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2
Q

When vessels DILATE

A

more blood to an area, more heat to an area

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3
Q

Excitement stimulates what gland?

A

Adrenal. Epinephrine squirted out to cause vasomotor changes

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4
Q

*** Body’s Thermostat controlled by

A

Hypothalamus (core body temp 98.6F/37C

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5
Q

*** Ways that heat is lost in body

A

1) Conduction (contact w cold surface)
2) Convection (layers of heat, clothing, hair etc)
3) Radiation (body heat radiates)
4) Evaporation (sweat, cooling process)

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6
Q

Axillary Temps

A

still used by least accurate. usually ~1* off

-in documentation, make sure to note HOW you took the temp

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7
Q

LABILE body temp

A

Baby’s up to 6 months have labile body temps that go up and down easily and quickly

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8
Q

Baby’s increased surface area to mass casuses

A

LABILE body temp

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9
Q

what method of temp taking is closest to core temp

A

Tympanic

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10
Q

Vegus Nerve

A 
The vagus nerve supplies motor parasympathetic fibers to all the organs except the suprarenal (adrenal) glands, from the neck down to the second segment of the transverse colon. The vagus also controls a few skeletal muscles, notable ones being:
Cricothyroid muscle, 
Levator veli palatini muscle
Salpingopharyngeus muscle
Palatoglossus muscle
Palatopharyngeus muscle

Superior, middle and inferior pharyngeal constrictors
Muscles of the larynx (speech).
This means that the vagus nerve is responsible for such varied tasks as heart rate, gastrointestinal peristalsis, sweating, and quite a few muscle movements in the mouth, including speech (via the recurrent laryngeal nerve). It also has some afferent fibers that innervate the inner (canal) portion of the outer ear (via the auricular branch, also known as Alderman’s nerve) and part of the meninges. This explains why a person may cough when tickled on the ear (such as when trying to remove ear wax with a cotton swab).

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11
Q

8 Pulse Sites

A

1) Temporal (not greatest, ensures blood going to head)
2) **Carotid (quickest, in emergency)
3) ** Radial (most common)
4) Brachial (mostly babies/toddlers)
5) Femoral (waist)
6) Popliteal (behind knee)
7) Tibialis Anterior (inner ankle)
8) Dorsalis Pedis (top of foot)

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12
Q

Factors that affect PULSE

A

1) Age (babies/rapid, adults/slower)
2) Sex (M/F because of body build)
3) Pain (will cause tachycardia)
4) Emotions (tachycardia)

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13
Q

*** Apical Pulse

A
  • @ 5th intersticial space
  • ** couple “s under left nipple
  • mid clavicle
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14
Q

*** Pulse Deficit

A
  • Difference between Apical and Radial pulse
  • ** 2 nurses and the same time perform. coordinate count
  • Apical can NEVER be less than Radial
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15
Q

Heart Rate affected by

A
  • Drugs, Caffeine, EPI (checmials)

- Emotions

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16
Q

*** if doing a radial pulse and it feels irregular what should you do?

A

do an Apical pulse for 1 FUL MINUTE to ensure you detect any irregularities

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17
Q

Breathing controlled in what part of brain?

A

Medula Oblongata

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18
Q

What meds slow BREATHIMG rates?

A

Opiates
Coma
Severe brain damage

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19
Q

Subjective

A

Cant see it. I’m nauseous, It hurts, It itches

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20
Q

Objective

A

Can see it, measurable. Rash, Vomit, Blood

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21
Q

To make pain more objective, assign number ranking to it and obtain frequently to see pattern

A

more measurable

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22
Q

Vital Signs

A
  • Body Temp
  • Pulse
  • Respiratory Rate
  • Blood Pressure
  • Pain (subjective) (5th Vital sign)
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23
Q

2 Body Temp Types

A

Shell: warmth of skin
Core: deep within body

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24
Q

Never take oral temp w/in 15-30 min of…

A

eating/drinking

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25
Factors affecting Body Temp
- Food intake - Climate (excercise/activity) - Circadian rhythm (temp up/down during day) - Emotions - Illness/Injury - Meds (Febrifuge; Aspirin, Ibuprofen, Acetaminophen)
26
Freezing
32*F | 0*C
27
Boiling
212*F | 100*C
28
Neuroleptic, Malignant Syndrom
severe fever. reaction to Haldol or other antiphychotic drugs. Anestesia can cause similar reactions
29
Danger zone for body temp (measured in F)
lower than 84*F (28.8*C), higher than 110*F (43.3*C)
30
Poikilothermic
body temp fluctuates depending on environmental temp (animals, snakes, lizards)
31
Homeothermic
structural/physiologic adaptations keep body temp stable (humans)
32
Body Temp Assessment sites
-Ear, Tympanic (closest to brain) -Temporal Artery -Sublingual -Rectal (most accurate)(not on cardiac patients though) -
33
Antipyretic
Reduce Fever, | Tylenol, Iburprofen
34
Temp Assessment probe colors
RED - Rectal | BLUE - Oral
35
Do no take ORAL temps on ...
- the unconscious - kids w colds - trauma to face - eating/drinking - mouth breathing
36
How to position Infrared Tympanic Thermometer.
Adult: pinna up and back. device on face like phone Child: tug earlobe down
37
Temp a Dots used for
Sublingual Temp | Isolation Rooms
38
Pulse Oximetry
device on fingertip measuring reading how red and oxygenated your blood is
39
Normal O level in blood
96 - 100*
40
Pyrexia
- Fever (exceeds 99.3*F) - bring temp down slowly to avoid shivering causing muscles to increase heat again. - increases metabollic demand, increasing glucose required, WBC require glucose
41
Hyperthermia
Inflammatory response. NOT FEVER. exceed 105.8* | sit in sauna too long, heat stroke etc
42
Cortizone
released during body during anti-inflammatory response
43
Diabetics taking cortisone causes....
Diabetics have to worry about fever and increase in cortizone? increased glucose.
44
Symptoms of Fever
- increase pulse - disorientation/confusion - Febrile seizures (infants/kids NOT EPILEPSY) - fever blisters - flush skin - restlessness - irritability/poor appetite - glassy eyes, sensitive to light - increased perspiration - headache
45
High Body temps damage
body cells
46
??? P63 | Intermittent Fever
normal up and down fever
47
??? P63 | Remitent Fever
temp changes up and down but never at NORMAL until patient is better.
48
Defervescence
fever breaking
49
Colder it gets, stronger Hemoglobin binds to O
- shivering stops because muscles can no longer get oxygen | - patient dies of Hypoxia, no freezing
50
Symptoms of Hypothermia
- shivering until it stops - pale, cool, puffy skin (vessels constrict to save heat) - impaired muscle coord (O functionally low) - Listlessness/irreg heart beat - slow pulse and breathing - incoherent thinking and diminished pain sense
51
Pulse
force exerted against wall of artery by L ventricular's contraction
52
Main Pulse Sites
Radial Brachial Apical (stethoscope)
53
average adult heart contractions
60 - 100 bpm at rest
54
RVR
- Pulse rythm (reg/irreg) - Pulse volume (bounding, weak, thready - Pulse rate (#bpm)
55
Pulse Volume Variations
- Absent - Thready - Weak - Normal - Bounding
56
Cardiac Output
volume of blood pumped by heart pm (mL blood/min). Cardiac output is a function of heart rate and stroke volume. CO = Hear Rate x Stroke Volume The heart rate is simply the number of heart beats per minute. The stroke volume is the volume of blood, in milliliters (mL), pumped out of the heart with each beat.
57
Pulse Assessment Technique
Radial artery
58
Alternate Assessment Techniques
- counting apical heart rate (auscultating) - apical - radial rate (Pulse Defecit, 2 nurses) - Doppler ultrasound over peripheral artery (used if can't palpate pulse)
59
Peripheral Pulse sites
- Apical - Temporal - Maxillary - Carotid (2) - Brachial (2) - Ulnar - Radial - Femoral (2) - Popliteal (2) - Posterior Tibial - Pedal (dorsalis pedis)
60
Body Temp UP, Pulse ?
Pulse UP
61
BP DOWN, Pulse ?
Pulse UP Cause heart beating harder
62
Dehydration, Pulse ?
Pulse UP
63
what will affect pulse?
Drugs, Caffeine, Meds,
64
Respiration
Exchange of Oxygen and CO2
65
Respiratory Rate
number of ventilations per minute
66
Cheyne-Stokes respiration
near death, severe brain damage (breath out, silence, gasp)
67
Kussmaul Breathing
prolonged exhale, trying to rid body of excess CO2. (when in metabolic acidosis) Diabetic Ketoacidosis
68
Rapid respiratory rate
Tachypnea (elevated temp, dissease affecting cardiac and/or respiratory sys)
69
Slow respiratory rate
Bradypnea | medication:opiates, neurological disorder, hypothermia
70
Diabetic Ketoacidosis
TriGlyceride. Glycerin breaks off top and leave 3 ketones. Body turns glycerol to glucose.
71
Narcan
anti opiate knocks out high immediately, increases HR
72
Why no enemas or digital stimulation in cardiac patients?
Because anal stimulation w stimulate Vegus nerve causing body to lower bp and pulse. If cardiac patient on mess already this would make it worse. Could pass out.
72
Why no enemas or digital stimulation in cardiac patients?
Because anla stimulation w stimulate Vegus nerve causing body to lower bp and pulse. If cardiac patient on mess already this would make it worse. Could pass out.
73
Orthostatic hypotension
When patient gets up too fast and bp drops they get weak
75
Abnormal Breathing characteristics
- Hyperventilation (rapid & deep) - Hypoventilation (slower/shallower) - Dyspnea (bad breathing, shortness) - Orthopnea (difficulty breathing laying down) - Apnea (no breathing) - Stertorous Breathing (noisy breathing) - Stridor (high pitch whistling noise) (indicate if wheezing is on inspiration or exhalation)
76
Blood Pressure
force blood exerts within arteries.
77
Normal Pulse rate
60 - 100
78
Normal BP rate
120/80
79
Vasodilation, ? pressure
Decrease
80
Vasoconstriction, ? pressure
Increase
81
?????? RAAS System
Review it
82
Caridac output at rest ~
5-6L
83
Arterial Pliancy
ability of arteries to stretch
84
LT HTN causes
Left Ventricular Hypertrophy (enlarged heart)
85
Factors affecting BP
- Age (lower in children) - Circadian Rhythm (day/nigh rhythm) - Gender (higher in men because more circulating volume) - Exercise and Activity - Emotions and pain
86
Orthostatic BP
BP sitting, standing and laying down
87
Orthostatic Hypotension
(postural hypotension), form of low blood pressure that happens when you stand up from sitting or lying down.
88
Blood Pressure increases when
-bladder full, legs crossed, person cold, drugs, caffeine
89
Systolic pressure
BP on Contraction
90
Diastolic pressure
BP at rest
91
BP units?
mmHg (mm of mercury)
92
BP
systolic/diastolic pressure
93
*** Pulse Pressure
difference btwn Systolic and Diastolic | 140/90 140-90 = 50
94
*** Pulse Defecit
Difference btwn Apical and Radial pulse
95
Don't take pressure on arms that.....
masectomy, major surgery, IV, etc
95
Essential Hypertension
(Aka primary hypertension or idiopathic hypertension) is the form of hypertension that by definition, has no identifiable cause. It is the most common type of hypertension, affecting 95% of hypertensive patients,[1][2][3][4] it tends to be familial and is likely to be the consequence of an interaction between environmental and genetic factors.
96
Arterial sclerosis
Hardened, stiff arteries
97
Arterial Sclerosis, ? BP
Increase
98
5th Vital Sign
Pain
99
Sphygmomanometer
BP Cuffs, dial face
100
Aneroid Manometer | Electronic oscillometric manometer
Automatic BP machine
101
Karatkoff Sounds
The first Korotkoff sound is the snapping sound first heard at the systolic pressure. Clear tapping, repetitive sounds for at least two consecutive beats is considered the systolic pressure. The second sounds are the murmurs heard for most of the area between the systolic and diastolic pressures.
102
2 stage BP
1) inflate cuff while palpating radial pulse | 2) when inflated high enough to obliterate pulse, record number and add 30 for starting point to inflate cuff.
103
How many high BP before diagnosis of HTN?
At least 3 high within couple weeks
104
What causes ED
Anti hypertensive drugs
105
Gerontological
- lower normal BP | - change in vasomotor (slower dilation and constriction)

Nursing, LPN, Year 1 (44 decks)

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